Grommets for Otitis Media With Effusion in Children With Cleft Palate: A Systematic Review
Grommets for Otitis Media With Effusion in Children With Cleft Palate: A Systematic Review
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DOI：
10.1542/peds.2014-0323
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发表时间：
2014-11-01
期刊：
影响因子：
8
通讯作者：
Shiao, An-Suey
中科院分区：
文献类型：
--
作者：
Kuo, Chin-Lung;Tsao, Yuan-Heng;Shiao, An-Suey
背景和目的：关于渗出性中耳炎(OME)、听力损失和腭裂儿童语言发育之间的联系，目前还没有达成共识。本研究的目的是探讨呼吸管插入术(VTI)治疗儿童腭裂OME的有效性。方法：采用双重回顾的方法，对PubMed、Medline Via Ovid、护理与相关健康文献的累积索引、Cochrane图书馆和参考文献列表中的符合条件的研究进行评估。根据文章全文选择可能相关的论文。相关数据被提取到数据提炼表上。结果：本研究纳入9项高质量或中等质量的队列研究。38%至53%的OME患者接受了VTI治疗，病情越严重的患者似乎更有可能接受VTI治疗。与保守的治疗方式(例如，警惕等待)相比，VTI已被证明有利于腭裂和OME儿童听力的恢复。越来越多的证据表明，VTI在腭裂和OME儿童的言语和语言发展中具有好处。与接受保守治疗的儿童相比，这些儿童面临更高的并发症风险，其中最常见的是鼓膜退缩和鼓室硬化，其发生率类似于11%至37%。结论：本综述为腭裂儿童OME的治疗选择提供了循证信息。需要更多的随机对照试验来获得能够可靠地指导治疗决定的抗偏见证据。这篇综述中的结论是基于力量不足的队列研究和非常缺乏说服力的证据。
BACKGROUND AND OBJECTIVE: No consensus has yet been reached with regard to the link between otitis media with effusion (OME), hearing loss, and language development in children with cleft palate. The objective of this study was to address the effectiveness of ventilation tube insertion (VTI) for OME in children with cleft palate.METHODS: A dual review process was used to assess eligible studies drawn from PubMed, Medline via Ovid, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and reference lists between 1948 and November 2013. Potentially relevant papers were selected according to the full text of the articles. Relevant data were extracted onto a data extraction sheet.RESULTS: Nine high-or moderate-quality cohort studies were included in this study. VTI was administered in 38% to 53% of the OME cases, and more severe cases appeared more likely to undergo VTI. Compared with conservative forms of management (eg, watchful waiting), VTI has been shown to be beneficial to the recovery of hearing in children with cleft palate and OME. A growing body of evidence demonstrates the benefits of VTI in the development of speech and language in children with cleft palate and OME. These children face a higher risk of complications than those undergoing conservative treatments, the most common of which are eardrum retraction and tympanosclerosis, with an incidence of similar to 11% to 37%.CONCLUSIONS: This review provides evidence-based information related to the selection of treatment for OME in children with cleft palate. Additional randomized controlled trials are required to obtain bias-resistant evidence capable of reliably guiding treatment decisions. The conclusions in this review are based on underpowered cohort studies and very-low-strength evidence.